Prof Ardagh, of Christchurch, is national clinical director
of emergency department services with responsibility for the
six-hour target.

He has taken an especially close interest in Dunedin, one of
the poorest performers in the six-hour target for patients to
be treated or transferred. The department has experienced
open hostility between doctors and Southern District Health
Board senior management in recent years.

''It's certainly a lot happier,'' Prof Ardagh said.

''There's a lot of history with Dunedin, which has been
described [in the Otago Daily Times] over the years.''

He believed periods of open tension could be healthy for
hospitals long term, because it brought things into the open.
For the past year, the Dunedin department consistently topped
90% in the six-hour target.

While Southern was still one of the poorest-performing boards
on the ED measure, it was a big improvement on the about 75%
achieved when the six-hour benchmark started in 2009.

This should be celebrated, while acknowledging work was
needed to meet the target of 95%, Prof Ardagh said. The New
Zealand approach to the emergency time target was better than
some other countries, he said.

It focused on putting good systems in place, not on
''gaming'' the system. He acknowledged the age of the Dunedin
facility, and agreed a redevelopment could help patient flow,
although it was possible to achieve the target without a new
facility, he said.